colon cancer, rectal cancer, esophageal cancer, liver metastases from colorectal cancer, pancreato-biliary cancer, peritoneal carcinomatosis from colorectal cancer, retroperitoneal sarcoma, abdominal aortic aneurysm, renal cancer, bladder cancer, supratentorial meningioma, hip arthrosis, knee or hip arthroplasty failure, osteosarcoma, pulmonary cancer, thoracic aortic aneurysm, head and neck cancer, mouth cancer, breast reconstruction, ovarian cancer, endometrial cancer, vulvar cancer
Conditions
Interventions
Patients will undergo a multimodal intensive prehabilitation program prior to high impact surgery including an exercise program, a nutritional intervention, psychological support and smoking cessation
Sponsors
Radboudumc
Eligibility
Inclusion criteria
Inclusion criteria: o Adult patients (>16 years), o scheduled for elective high impact surgery, o independent of (neo-) chemotherapy and/or radiotherapy, o obtained written informed consent.
Exclusion criteria
Exclusion criteria: o Paralytic or immobilized patients who are not able to complete exercise intervention, o premorbid conditions or orthopedic impairments which contraindicate exercise, o inability to undergo the intervention due to lack of understanding or instructability (e.g. cognitive disability or illiteracy (disability to read and understand Dutch)). o unstable cardiac or respiratory disease which contraindicate exercise, o renal failure stage 3 or higher which contraindicate protein supplementation o ASA score 4 or higher,
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| To determine the effects of a multimodal intensive prehabilitation program a high-risk patient group on complications (Clavien-Dindo score and Comprehensive Complication Index (CCI) score) | — |
Secondary
| Measure | Time frame |
|---|---|
| To investigate the effects of multimodal intensive personalized prehabilitation on an: - Individual patient’s level, i.e. length of hospital stay (in days), physical fitness (estimated VO2 peak, indirect 1 repetition measures, physical activity), nutritional status (body weight, fat-free mass), mental health (HRQoL), intervention adherence - Mechanistic level, i.e. innate immune response (degree of immunoparalysis) - Hospital-efficiency level: costs due to complications, costs due to length of hospital stay, budget impact, cost-effectiveness - Macro-economic level: changes in patients volumes, shifts in care between 2nd and 1st line healthcare | — |
Contacts
Public ContactDieuwke Strijker
Radboudumc
Outcome results
None listed